The idea of paradoxical intention is to subject the patient to those situations that cause anxiety so that he learns to manage the discomfort.
In life, there are few situations more frustrating than lying in bed unable to fall asleep.
Many of us have had the experience of tossing and turning under the covers while watching the incessant march of the minutes on our clock, step by step, bringing us closer to the dreaded hour when the alarm clock will go off.
However, there is a psychological method that some sleep science experts recommend for those days when it seems like Morpheus has forgotten about us.
It’s about playing and trying to stay awake.
“ In paradoxical intention, we say and do exactly what we fear most. In the case of insomnia, it is inviting you to stay awake,” Dr. Katharina Lederle, a psychologist specializing in sleep and circadian cycles, tells BBC Mundo.
The paradoxical intention
Paradoxical intention is a term coined by the creator of the psychological school of logotherapy, Dr. Viktor Frankl, who developed it to help people with extreme anxiety disorders.
Frankl himself explained it this way: “ The patient is motivated to do or want to happen the very thing he fears so much. ”
The idea of paradoxical intention is to subject the patient to those situations that cause anxiety, generally in an exaggerated or even comical way so that he or she becomes accustomed to and learns to manage the discomfort that is felt internally.
For example, if a person has a fear of public speaking and that fear is expressed internally as an increased heart rate, with paradoxical intention the patient would be asked to imagine himself increasing his heart rate to the point where it stops.
By putting the patient in these extreme situations and guiding them through the emotions they are feeling, the therapist can help the person feel more comfortable with uncomfortable sensations and, in the process, lose their fear of them.
Dr. Colin A. Espie of the University of Oxford wrote in an article in the journal Therapy in Sleep Medicine that “ paradoxical intention is useful for those who have intense concerns about sleep, sleep loss, and its consequences .”
Curiosity
For some, this fear ends up being the starting point of a vicious cycle of anxiety and insomnia that is reflected in a feeling of anxiety when thinking about sleeping.
“What we would do with paradoxical intention would be the opposite, inviting ourselves to stay awake,” explains Dr. Lederle.
“That is, you have to stay in bed with your eyes open saying something like ‘Okay, I’m going to stay here a little longer with my eyes open.’”
The idea is to lose the fear of sleep, says Lederle, and to stop it from being an idea that causes us anxiety through curiosity.
“You could think of it as ‘how long can I last with my eyes open?’, always staying curious. Curiosity is a trait that helps us in many aspects of life, particularly in sleep.”
“It’s being curious about what your mind is doing and what’s going on in your body. It’s stopping thinking about what you have to do the next day and asking yourself what you’re feeling when you’re lying there waiting for sleep.”
The idea is also, contrary to what some experts recommend, to stay in bed while trying to stay awake, because, according to Lederle, that is what gets us to sleep the fastest.
“Being in bed, in the dark, is the best way to fall asleep,” he says.
Important, but not so much
Dr. Lederle says that while there are studies supporting the use of paradoxical intention to help you fall asleep, the method can also create an expectation, which can put you on alert and undermine your intention.
“It may be effective at first, but if I keep telling myself to keep my eyes open for a while because it worked for me three nights ago, I’ll have this expectation of ‘when is it going to happen? ‘”
“ Sleep is immensely important, but we don’t want to put it on a pedestal. The best sleep comes when you don’t strive for it when you don’t pay attention to it. You value it, but you don’t pay attention to it.”
Lederle says the best way for her patients to get the best sleep possible is to make it consistent and to organize their lives around the sleep time they need to function.
“If I live a healthy life and I know how much sleep I need, I organize myself around that, and I don’t have to think about it too much. That’s how you reset your circadian rhythm.”